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Pay attention to ovarian function in patients with breast cancer susceptibility gene mutations
ovarian function in patients with breast cancer susceptibility gene mutations. Breast cancer susceptibility genes BRCA1 and BRCA2 are important tumor suppressor genes.
Breast cancer susceptibility genes BRCA1 and BRCA2 are important tumor suppressor genes. Once pathogenic variants occur, they are likely to cause breast cancer and other malignant tumors. Deoxyribonucleic acid (DNA), which carries a large number of genes, has the ability to repair itself and avoid genetic mutation.
Once the DNA repair defect occurs, it is not only easy to cause breast cancer, but also easy to cause aging of reproductive function. Recent studies have shown that due to DNA repair defects, women with BRCA pathogenic variants may have lower ovarian function reserve.
However, the results of clinical studies using the most sensitive serum indicator of ovarian function reserve-Miller tube (also called pararenal tube, formerly known as Mullerian tube, Mullerian tube) to inhibit hormones are contradictory and inconsistent.
On April 23, 2021, the American Society of Clinical Oncology “Journal of Clinical Oncology” published online at Yale University, Los Angeles Cida Sina Medical Center, University of California, Los Angeles Johnson Comprehensive Cancer Center, University of California, Davis, Turkish Medical University, The research report of San Martino General Hospital of University of Genoa in Italy, Samsung Seoul Hospital of Sungkyunkwan University in South Korea, Henri Becquerel Center in France, and the Free University of Brussels in Belgium. The general term, formerly known as germline) whether BRCA pathogenic variants are related to ovarian functional reserve.
The study first conducted a literature search on the National Library of Medicine database, and finally screened out 5 studies from 12 articles. A total of 828 evaluable women who had undergone germline BRCA testing were subjected to a meta-analysis of individual patient level data. Among them, 250 cases carried germline BRCA pathogenic variants, and the remaining 578 cases did not carry germline BRCA pathogenic variants as controls. For women with germline BRCA pathogenic variants, 4 studies analyzed 161 women with breast cancer, and 1 study analyzed 89 women without breast cancer. Before the final analysis, the research center, age, body mass index, smoking, oral contraceptives and other influencing factors were adjusted. Before systemic treatment, the Miller tube inhibitory hormone levels of women with germline BRCA pathogenic variants were measured.
As a result, the average age of women with and without germline BRCA pathogenic variants was similar (34.1±4.9 vs. 34.3±4.8 years, P=0.48), and the average age of women with germline BRCA1 and BRCA2 pathogenic variants was similar (33.7±4.9) Than 34.6±4.8 years old, P=0.16).
After adjusting for other influencing factors:
Compared with women with and without germline BRCA pathogenic variants, the level of Miller tube inhibitory hormone was 23% lower (95% confidence interval: 4 to 38, P=0.02).
Compared with women with breast cancer (157 cases vs. 524 cases) who did not carry germline BRCA pathogenic variants, the level of Miller’s tube inhibitory hormone was 25% lower (95% confidence interval: 9-38, P=0.003).
After adjusting for other influencing factors, compared with women who do not carry germline BRCA pathogenic variants:
Women with germline BRCA1 pathogenic variants: Miller canal inhibitory hormone levels are 33% lower (95% confidence interval: 12 to 49, P=0.004)
Women with germline BRCA2 pathogenic variants: Miller tube inhibitory hormone levels are 7% lower (95% confidence interval: -31～26, P=0.64)
Therefore, the results of this study show that for young women with germline BRCA pathogenic variants, especially breast cancer women with germline BRCA1 pathogenic variants, compared with women who do not carry germline BRCA pathogenic variants, the Miller tube suppresses Hormone levels are significantly lower. For young women with reduced ovarian function reserve, priority consultation may be required regarding the possibility of shortened reproductive life, and ovarian function protection treatment should be actively considered, especially for breast cancer patients with BRCA1 pathogenic variants who require chemotherapy or delayed childbirth.
(source:internet, reference only)